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Customer Care Representative I

2 months ago

Lancaster, Pennsylvania, United States Lancaster General Full time
Overview

Position Overview

ROLE SUMMARY: The Customer Care Representative I is responsible for providing comprehensive and precise scheduling, registration, insurance verification, and coordination of necessary outpatient services. This role supports patients by addressing their expressed and unexpressed needs, fostering meaningful connections with each individual.

WORK SCHEDULE: 32 hours per week, Monday to Friday during daytime hours, with occasional Saturday shifts from 8:00 AM to 12:00 PM. Initial training spans 4 weeks, Monday through Friday from 9:00 AM to 5:30 PM. Remote work may be available after 6 months in the position, contingent upon meeting departmental objectives.

KEY RESPONSIBILITIES: Qualified candidates must possess the capability (with or without reasonable accommodation) to execute the following tasks:
  • The Customer Care Representative I is fully trained in one of the two phases (I or III) detailed below.
  • PHASE I
    • Schedule appointments for laboratory tests, imaging services, and other diagnostic procedures.
    • Accurately input ancillary orders, requiring the interpretation of medical terminology from healthcare professionals.
    • Identify and gather essential information when entering orders, including the ordering provider and diagnosis codes.
    • Collect and accurately enter patient insurance details into the system.
    • Ascertain if an appointment necessitates an insurance referral or authorization and document accordingly to ensure payment.
    • Review and interpret electronic verification responses from insurance providers and update the system as needed.
  • PHASE III
    • Handle incoming calls for Family Medicine and Specialty Medicine practices, which may involve scheduling appointments, creating patient encounters, and transferring calls to Triage.
    • Schedule appointments following the guidelines in the internal resource manual to ensure compliance with protocols.
    • Follow approved escalation procedures by asking patients additional questions to determine the best course of action for their safety (e.g., scheduling an appointment, transferring to Triage Nurse, or advising to call emergency services).
    • Create and send telephone and triage encounters to physician offices using professional language to accurately convey patient messages.
    • Collaborate with clinical and non-clinical staff to ensure timely resolution of patient needs.
    • Gather patient insurance information to verify coverage and participation.
ADDITIONAL RESPONSIBILITIES: The following tasks are considered secondary to the primary responsibilities outlined above:
  • Deliver exceptional customer service by identifying and addressing patient needs through personal engagement and strong interpersonal skills.
  • Exhibit the ability to adapt to frequent changes in procedures, protocols, and workflows.
  • Document patient interactions clearly and concisely to provide accurate information to clinical staff.
  • Complete additional duties and special projects as assigned by management.
QUALIFICATIONS

MINIMUM REQUIRED QUALIFICATIONS:
  • High school diploma or equivalent (GED).
  • One (1) year of experience in clerical, customer service, or administrative support roles within a customer-focused environment.
  • One (1) year of experience with keyboarding, personal computer usage, and office equipment.
PREFERRED QUALIFICATIONS:
  • Three (3) years of experience in clerical, customer service, or administrative support roles within a customer-focused environment.
  • One (1) year of experience in medical office or outpatient scheduling/registration.
  • One (1) year of experience with electronic medical records.
  • One (1) year of experience in revenue cycle management within a medical office or hospital setting.
COGNITIVE REQUIREMENTS

Attention/Concentration: The following level of ability is essential for the jobholder to focus on certain aspects of current experience and reject others.
  • The position requires the ability to manage multiple tasks simultaneously, as various demands will likely arise concurrently.
Learning and Memory: The following level of ability is essential for the jobholder to learn and retain material.
  • The position necessitates the ability to quickly and effectively learn new tasks, as job requirements may frequently change. Understanding and executing detailed instructions is crucial.
Problem Solving and Reasoning: The following level of ability is essential for the jobholder to think critically to resolve issues by integrating elements from past experiences or creative thought.
  • The position involves addressing problems that often require thoughtful reasoning to arrive at solutions. Independent thought and planning are necessary to generate options and solutions, applying principles of reasoning to resolve practical issues.
APTITUDES: The following are essential requirements of the position in relation to job-worker situations. These items describe how a worker must adapt, adjust, conform, or act.

Variety and Change: Ability to perform a range of duties, often shifting from one task to another of a different nature without loss of efficiency or composure, involving significant differences in technologies, techniques, procedures, environmental factors, physical demands, or work situations.

EQUIPMENT USAGE REQUIREMENTS

Equipment/Tools: Computer, Phone, Copier, Printer, Fax, Office Supplies

Software: Microsoft Office Products, Electronic Medical Record System

PHYSICAL REQUIREMENTS

Body Position/Movement:
  • Sit: Continuously 71-100%
  • Stand: Rarely 0-10%
  • Walk: Rarely 0-10%
  • Bend: Rarely 0-10%
  • Push: Rarely 0-10%
  • Pull: Rarely 0-10%
  • Kneel/Squat: Rarely 0-10%
  • Reach: Rarely 0-10%
  • Twist: Rarely 0-10%
  • Balance: Rarely 0-10%
  • Climb: Rarely 0-10%
Lifting: Degree of physical exertion is:
  • Light, exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to move objects.
Sensory Abilities specifically required:
  • Vision
  • Hearing
WORKING CONDITIONS:
  • Exposure to hazardous conditions/materials is negligible.
Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to reflect those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards. The percentages of time spent performing job duties are estimates and should not be considered absolute. The incumbent shall perform all other functions and/or be cross-trained as determined at the sole discretion of management, who reserves the right to amend, modify, or terminate this job in part or in whole. The incumbent must be able to perform all job functions safely.

Benefits Overview:

PENN MEDICINE LANCASTER GENERAL HEALTH offers a range of benefits to employees:
  • 100% Tuition Assistance at The Pennsylvania College of Health Sciences
  • Paid Time Off and Paid Holidays
  • Shift, Weekend, and On-Call Differentials
  • Health, Dental, and Vision Coverage
  • Short-Term and Long-Term Disability
  • Retirement Savings Account with Company Matching
  • Child Care Subsidies
  • Onsite Gym and Fitness Classes
Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion, or any other classification protected by law.